Dear Pharmacist,Sometimes my tongue gets bald, red patches or a thick yellowish coating on it. I can’t figure out why this happens or what it means. My doctor says that it’s nothing to worry about. Do you agree?

-A.P., Ocala, Fla. Hi A.P.,I agree with your doctor: Don’t worry, because worrying is a useless emotion that may actually cause more health problems. Your time is better spent on finding out why this condition is recurring and then preventing episodes.

You describe what is called “geographic tongue” because it looks like a map. The smooth, red patches are surrounded by grayish white areas, and the patchy areas can change location from day to day. The tiny bumps on the tongue called “papillae” fall off, causing patches, but they’re able to grow back.

Acupuncturists and Chinese medicine doctors would never dismiss your tongue. It’s the first body part they want to see because it assists them in their diagnosis. Hey, I’d rather stick out my tongue and say ahhh, than get needled for blood and biopsies, wouldn’t you? And yes, I’ve had a tongue reading myself.

To find a solution, you have to determine the cause. Geographic tongue may indicate a hormonal imbalance, low thyroid, liver disease, yeast overgrowth or a weakened immune system. Poor intestinal health, antibiotic use, liver disease, a bile disorder and digestive disorders (like Celiac, Crohn’s, IBS) all impact the color and texture of your tongue. People with methylcobalamin (B12) deficiencies and other B vitamin deficiencies have tongue issues.

There are hundreds of drug muggers of B vitamins. Among them are antibiotics, antifungals, antacids, heartburn medications, certain blood pressure pills, female hormones and most anti-inflammatories. Geographic tongue is not the only situation of the tongue. Read below, and if you’re curious, visit my Web site to see actual photographs: Scalloped tongue – It’s usually thick or swollen and has a scallop design around the outer edge. This is usually related to sluggish spleen or thyroid function. Pale tongue – This condition could be tied to pernicious anemia or iron deficiency anemia. Vertical crack – May signify difficulties in the stomach or heart. If the crack extends down the middle, but doesn’t reach the very tip, it’s most likely related to digestion. Black, hairy tongue – Dark-colored bacteria/fungus build up on the papillae and instead of shedding, they grow longer creating the hairy appearance. The “hair” color may be white, yellow, green or brown colors depending on the color of your invading organism. Glossopyrosis – Also called “Burning Mouth Syndrome,” it may be related to Candida albicans overgrowth, B12, riboflavin or folic acid deficiency, insufficient probiotics and imbalanced hormones.

You may be able to prevent episodes by supplementing with high-quality immune-boosting supplements, probiotics, activated B complex, in particular methylcobalamin and 5-MTHF and digestive enzymes.Did You Know? If you’re allergic to lactose, you should avoid anything with caramel color.

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